Adjunctive fixation of the humeral epicondyle in a lateral condylar fracture model: Ex vivo comparison of pins and plates with a novel composite (AdhFix)

• Published in: Veterinary surgery Vol. 53; no. 2; pp. 311 - 319
• Main Authors: Quinn, Robert J., Höglund, Odd V., Hutchinson, Daniel J., Opande, Lola, Lim, Edward, Birgersson, Ulrik, Granskog, Viktor, Malkoch, Michael
• Format: Journal Article
• Language: English
• Published: Hoboken, USA John Wiley & Sons, Inc 01-02-2024; Blackwell Publishing Ltd
• Subjects: Animals; Biomechanical Phenomena; Biomechanics; Bone Nails - veterinary; Bone Plates - veterinary; Cadaver; Cadavers; Clinical Science; Contouring; Dog Diseases; Dogs; Fixation; Fracture Fixation, Internal - methods; Fracture Fixation, Internal - veterinary; Fractures; Humans; Humeral Fractures - surgery; Humeral Fractures - veterinary; Humerus; Humerus - surgery; Klinisk vetenskap; Mechanical properties; Reconstruction; Ultimate loads; Wire
• ISSN: 0161-3499; 1532-950X; 1532-950X
• DOI: 10.1111/vsu.14048

Objective
To compare the biomechanical properties of using a novel composite construct (AdhFix) to an interfragmentary Kirschner wire or a reconstruction plate as adjunctive epicondylar stabilization in simulated lateral unicondylar humeral fractures.
Study design
Cadaveric biomechanical assessment.
Sample population
Paired humeri harvested from skeletally mature dogs (14–41 kg), nine cadavers per group.
Methods
Simulated lateral unicondylar humeral fractures were stabilized with a transcondylar 4.5 mm cortical screw placed in lag fashion. Adjunct fixations consisting of a novel composite incorporating 2.7 mm cortical screws on one side, and either a 2.7 mm reconstruction plate or a 1.6 mm Kirschner wire on the contralateral side, were tested within paired humeri. Repaired humeri were axially loaded to failure and construct stiffness, yield load, and ultimate load were obtained from the load‐deformation curves.
Results
In pairwise comparison, yield load was significantly higher for AdhFix group compared to the pin group, p = .016. No statistical significance was seen in the comparison between AdhFix group and the plate group, p = .25.
Conclusion
Adhfix was mechanically superior to K‐wires, and comparable to plate fixation, for adjunctive fixation in a lateral humeral condylar model. Our results support further investigation of the novel composite for adjunct fracture fixation in lateral humeral condylar fractures.
Clinical significance
The novel composite tested may be a viable alternative for adjunct fixation of humeral condylar fractures, a technique that circumvents plate contouring.